Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.75 / $107.86 / $477.09	Facility		$64.75	$107.86	$477.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.75 / $108.91 / $408.70	Professional		$64.75	$108.91	$408.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.31 / $109.10 / $201.25	Professional		$102.31	$109.10	$201.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.36 / $90.93 / $102.60	Facility		$78.36	$90.93	$102.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.64 / $123.08 / $214.54	Professional		$80.64	$123.08	$214.54
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $88.30 / $115.00 / $139.00	Facility		$88.30	$115.00	$139.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $137.38 / $311.61	Professional		$100.00	$137.38	$311.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.81 / $110.81 / $110.81	Facility		$110.81	$110.81	$110.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.98 / $128.22 / $260.75	Professional		$78.98	$128.22	$260.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $54.83 / $54.83 / $65.80	Professional		$54.83	$54.83	$65.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.72 / $138.03 / $245.69	Professional		$83.72	$138.03	$245.69
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $373.93 / $405.70 / $405.70	Facility		$373.93	$405.70	$405.70
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $526.12 / $743.11 / $743.11	Professional		$526.12	$743.11	$743.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $85.00 / $180.42	Professional		$60.00	$85.00	$180.42
Optum Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $129.30 / $246.32	Professional		$105.00	$129.30	$246.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.06 / $114.97 / $180.26	Facility		$69.06	$114.97	$180.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.98 / $144.29 / $286.92	Professional		$81.98	$144.29	$286.92
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $105.00 / $105.00	Facility		$105.00	$105.00	$105.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $130.47 / $246.32	Professional		$105.00	$130.47	$246.32
United Facility/Professional Facility Modifier Low / Median / High Price $135.91 / $135.91 / $135.91	Facility		$135.91	$135.91	$135.91
United Facility/Professional Professional Modifier Low / Median / High Price $86.57 / $121.68 / $297.55	Professional		$86.57	$121.68	$297.55